1. Trauma-FIT Trauma- Focused Individual Training Revised and Updated January 2005

2. Trauma-FIT Trauma Focused Individual Training “T-FIT”

3. Trauma-FIT What is T-FIT? Focused medical training for non-medical personnel designed to provide critical medical intervention at the site of injury.

4. Trauma-FIT Who Developed the Course? COL Cliff Cloonan, Assistant Professor Military & Emergency Medicine Department Developed the course based on his operational experience as SOCOM Surgeon.

5. Trauma-FIT Command Emphasis 1 st Brigade (Warrior) Brigade Commander COL William Garrett (2003) directed implementation and fielding of program within Warrior Brigade.

6. Trauma-FIT 100:50:25:2 “Rule” 100% of unit strength CLS trained 50% of unit strength T-FIT trained 25 (approx) Combat Medics assigned 2 Advanced Trauma Management (ATM) Providers Based on Battalion/Squadron sized element

7. Trauma-FIT Course History The first formal class was taught to soldiers assigned to 1-32 Infantry Battalion, 1 st Warrior Brigade, 10 th Mountain Division in February 2003

8. Trauma-FIT Initial Course Developers Major Chadwick- 1 st Brigade Surgeon CPT Pataky- Battalion Physician Assistant Medics of 1-32 Infantry

9. Trauma-FIT Baptism Under Fire The courses further development began in Operation Iraqi Freedom for Task Force Chosin. Training was developed based on requirements as identified during combat operations beginning October 2002

10. Trauma-FIT Course Improved Development MAJ Jack Hurley- 82 nd Airborne Division CPT Michael Franco- 82 nd Airborne Division 1LT Edwin Guiterrez- 10 th MTN DIV 1LT Thomas Moody 10 th MTN DIV SFC Douglas Mack- 10 th MTN DIV SSG Conway Halladay- 10 th MTN DIV SGT Joshua Pierrpont- 10 th MTN DIV

11. Trauma-FIT Program of Instruction Writers 1LT Edwin Gutierrez 1LT Thomas Moody

12. Trauma-FIT DEDICATION This course is dedicated to all soldiers of Task Force Chosin and most importantly to those who made the ultimate sacrifice.

13. Trauma-FIT Prerequisites Successfully complete the Combat Life- Savers course. Passing CLS written examination of 90% or better on written exam. Top 25%-50% of CLS course.

14. Trauma-FIT Course Requirement Pass all individual practical skills testing Pass all group practical skills Score 80% or better on written examination

15. Trauma-FIT Individual Practical skills Maintain an open airway Perform mouth-to mask ventilation Insert an oral pharyngeal airway Insert a nasal pharyngeal airway Apply dressing for sucking chest wound Perform trauma patient assessment Perform I.V. administration Apply tourniquet Request MEDEVAC Perform patient triage

16. Trauma-FIT Team Practical skills Manage trauma patient Manage mass casualty

17. Trauma-FIT Lectures Introduction to T-FIT Combat Casualty care/Tactical Care Under Fire Triage/Mass Casualty Management Patient Assessment Trauma Patient Airway management

18. Trauma-FIT Lectures (Continued) Head Trauma Chest/Abdominal Trauma Extremity Trauma Burns Altitude Sickness MEDEVAC Procedures

19. Trauma-FIT Course Comparison (Lectures) ClassT-FITRFR Airway ManagementYY Patient AssessmentYY Thoracic TraumaYY Abdominal TraumaYY IV ManagementYY Tactical Combat casualty care YY Extremity TraumaYY Altitude MedicineYN TriageYY BurnsYN ShockYY Heat InjuriesNY

20. Trauma-FIT Course Comparison (Practical Skills) SkillT-FITRFR Airway ManagementYY Patient AssessmentYY Seal Open Chest woundYY Needle Decompression Tension Pneumothorax YY IV ManagementYY Tactical Combat casualty care YY Hemorrhage ControlYY TriageYY MEDEVAC ProceduresYN

21. Trauma-FIT Recommended Course length 2- 15 hour/ Day 3- 12.5 hour/Day 4- 10 hour/Day 5- 8 hour/Day

22. Trauma-FIT Recommend Supplies IV fluid (NS)-100 IV Tubing- 100 Needle Catheter-200 Alcohol pads-200 Tourniquets-20 Gloves- 100 Band Aid- 100 Sharp Container- 5 Chux- 100 CLS bags- 25 Asherman Chest seal- 25 Ratchet Tourniquet-5 Quik Clot- 2 (demonstration only) Airway Mannequin- 1 Based on class size of 25 soldiers

23. Trauma-FIT Recommend Supplies Tape 1 inch- 15 Field Dressing- 25 Cravats- 25 Israeli Dressing- 25 Kerlix- 50 FAST-1 (demonstration only) Litters- 4 ACE Wrap 3 inch- 5 Oral Pharyngeal - 10 Nasal Pharyngeal- 10 Laptop-1 Proxima-1 Based on class size of 25 soldiers

24. Trauma-FIT Training Schedule DAYTIMECLASSFORMATINSTRUCTOR 10900INTRODUCTIONLECTUREATM PROVIDER 1000Tactical Combat Casualty CareLECTUREATM PROVIDER 1100TriageLECTUREATM PROVIDER 1200LUNCH 1300Patient AssessmentLECTUREATM PROVIDER 1400Skills Station 1) Airway Management 2)Needle decompression 3) Hemorrhage Control 4) Seal Open Chest Wound 5) Triage Hands-on PracticeMEDICAL NCO 1700End of Training Day

25. Trauma-FIT Training Schedule DAYTIMECLASSFORMATINSTRUCTOR 20600Shock Management 0700Airway ManagementLECTUREATM PROVIDER 0800Head Trauma ManagementLECTUREATM PROVIDER 0900Chest/Abdomen Trauma ManagementLECTUREATM PROVIDER 1000Extremity Trauma ManagementLECTUREATM PROVIDER 1100BurnsLECTUREATM PROVIDER 1200LUNCH 1300Altitude SicknessLECTUREATM PROVIDER 1400Skills Station 1) Airway Management 2)Needle decompression 3) Hemorrhage Control 4) Seal Open Chest Wound 5) Triage Hands-on TestingMEDICAL NCO 1700End of Training Day

26. Trauma-FIT Training Schedule DAYTIMECLASSFORMATINSTRUCTOR 30700Written Exam 0800Trauma Challenge Prep ATM PROVIDER 1000Trauma Challenge Graded Practical Exercise Hands-onMEDICAL NCO 1200LUNCH 1300Trauma Challenge Graded Practical Exercise Hands-onMEDICAL NCO 1700Certificate Issue Commander’s Comments After-Action Review 1700End of Training Day

27. Trauma-FIT Certificate of Training presented by 1 st Squadron, 71 st Cavalry 10 th Mountain Division, Fort Drum New York To For ________________________________ Thomas U. Moody, MPAS, RPA-C 1LT, SP Physician Assistant ________________________________ Mark Meadows LTC, IN Commanding 09 Nov. 2003 – 13 Nov. 2003 PV2 John David 111-111-1111 Successful completion of 40 hours of Trauma Focus Individual Training

28. Trauma-FIT T-FIT Packing List Adhesive tape, surgical porous woven 1in.x10yrds 1 Airway, pharyngeal large adult 1 Airway, pharyngeal small adult 1 Bandage adhesive 3/4inx3in chest flesh (band-aid) 18 Bandage muslin compressed (cravat) 37x37x52 triangular 4 Case medical instrument and supply (CLS bag) 1 Catheter needle unit d121 V 18ga 4 Bandage, pressure, Israeli 2 Dressing, first aid, field camouflaged 4x6.25x7.25 lg abs 6 Gloves patient exam-large (latex) 2 Intravenous inj set 7compmacrodrip10drops/ml 2 Catheter 14ga 2.5in 2 Asherman chest dressing 2 Pad povidone-iodine impre ster2x1 375”brown (iodine pads) 12 Povidone-iodineointUSP10% 1/8oz. (3.54 gram) (iodine ointment) 8 Ringers lactate injection USP 500ml plastic bag 2 Scissors, bandage 1.5” cut large 7.25” 7 Alcohol preps 25 Field dressing, first aid 7x2x8 2 Sam splint 1 Nasopharyngeal airway 4 2x2” gauze sponges 12 Tourniquet Ratchet 1